“¡Míranos! Look at Us, We Are Healthy!” – an early childhood obesity prevention program

Data from a clustered randomized controlled trial of 12 Head Start Centers in San Antonio, Texas: <b>!Míranos! Look at Us, We Are Healthy! (¡Míranos!</b>)<br>The prevalence of obesity remains high in American children aged 2-5 while one in three Head Start children is overweight or obese. The !Míranos! study was designed to test the efficacy of !Míranos!, an early childhood obesity prevention program, which promoted healthy growth in predominantly Latino children in Head Start. The Míranos! included center-based (policy changes, staff development, gross motor program, and nutrition education) and home-based (parent engagement/ education and home visits) interventions to address key enablers and barriers in obesity prevention in young children. In partnership with Head Start, the study team demonstrated the feasibility and acceptability of the proposed interventions to influence energy-balance-related behaviors favorably in Head Start children. Using a three-arm cluster randomized design, 21 Head Start centers in equal numbers wiere randomly assigned to one of three conditions: 1) a combined center- and home-based intervention, 2) center-based intervention only, or 3) control. The interventions were delivered during the academic year (an 8-month period). A total of 526 3-year-old children were enrolled in the study and followed prospectively one year post-intervention. Outcome data collection was conducted at baseline, immediate post-intervention, and 1-year follow-up and included height, weight, physical activity (PA), and sedentary behaviors by accelerometry, parent reports of sleep duration and TV watching time, gross motor development, dietary intakes, and food and activity preferences. Information on family background, parental weight, PA- and nutrition-related practices and behaviors, PA and nutrition policy and environment at center and home, intervention program costs, and treatment fidelity will also be collected. The study had three specific aims: 1) to test the efficacy of the !Míranos! intervention on healthy weight growth (primary outcome) in normal weight, overweight and obese children, 2) to test the impact of the !Míranos! intervention on children’s PA, sedentary behavior, sleep, and dietary behaviors (secondary outcomes), and 3) to evaluate the cost-effectiveness of the !Míranos! intervention. By targeting different levels of influence and in multiple settings, the !Míranos! showed great promise of developing long-term health habits that reduce the energy imbalance gap by targeting multiple energy-balance-related behaviors. The !Míranos! can be disseminated to various organized childcare settings since it is built on the Head Start program and its infrastructure—a gold standard in early childhood education, as well as current PA and nutrition recommendations for preschool children.<br>